Introduction
Nasal injuries during sports are very common in children and adults when getting hit with sports equipment such as baseballs, hockey sticks, or softballs or an opponent player hit. In the maxillofacial complex, nasal bones are the commonly fractured bony structures. This is because of the protruding position of the nasal bone coupled along with its relative lack of support. Injuries may occur only to the nose or with other facial fractures, like fractures of the upper and lower jaw or the bone around the eye. The leading causes of injury include sports-related injuries, motor vehicular accidents (MVA), and unintentional falls.
Sports-related injury is the major cause of nasal bone fractures in adolescents. These injuries can cause bleeding and facial disfigurement occurring along with facial trauma leading to great anxiety for the parents of injured children or the patients. Prompt appropriate treatment prevents cosmetic and functional changes. Also, due to the central location of the nose and proximity to important structures, healthcare professionals should cautiously look for any other injuries in the face in the presence of facial fractures.
What Are the Common Nasal Injuries?
Nose Fractures
Nose fractures also known as broken nose are the most common type of nose injury. There are two types of nose fractures: open and closed nose fractures. When the skin is broken and the bone is damaged it is called an open nose fracture and when there is no injury to the skin and the bone is damaged it is called a closed nose fracture.
The symptoms of a broken nose include pain and inflammation, bruising around the nose or eyes which may appear as a black eye, a grating sensation or sound when touching the nose, a nosebleed, or an excessively runny nose. A person should be immediately taken to the hospital if there is a large and profusely bleeding wound, difficulty with breathing, or drainage from the nostrils due to cerebrospinal fluid from the brain.
Surgery or realignment of the nose may be done as treatment. Till the nose injury heals the patient can be out of activity for a period. Ice compression or pain medication can be used to reduce other symptoms.
Nose Bleeding
A cut on the nose is a common injury and usually a fairly minor injury. It can occur following a blow to the nose. This is due to the fragile blood vessels in the nose, even any irritation such as excessive scratching can cause bleeding. Excessive blood does not always require medical attention. It can be treated by applying ice to the nose to compress the blood vessels and pinching the nose for several minutes can also enhance the clotting process. But even after all these treatments, if there is no decrease in the bleeding then stitches can be necessary. Also, there is an increased chance of infection in an open wound. Several hours after the trauma, bruises may appear and this might be accompanied by tenderness and swelling. Usually, these symptoms can be reduced by icing the area.
Hematoma (Collection of Blood)
Sometimes, the clotted blood from a broken nose gets collected, leading to a condition called a septal hematoma. When there is a blood clot collected in the nostrils, it can lead to the blockage of one or two nostrils. Treatment for septal hematoma is surgical drainage to prevent cartilage damage.
Deviated Septum
A thin wall of bone or cartilage that divides the two sides of the nose is displaced to one or another side and is called a deviated septum. Sudden trauma is the main cause of this condition, in some cases, it occurs due to birth deformity.
The common symptoms of deviated septum include:
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Frequent nose bleeds.
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Sleeping issues.
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Difficulty while breathing.
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Postnasal drip.
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Loud snoring.
The treatment for nasal septum deviation often includes a surgical procedure to restore alignment.
Other Injuries
If a blow is strong enough to break the nose, there are chances to damage the bones in the neck. It is also important to check for other injuries like head and facial injuries. If any injury is suspected, seek medical care immediately.
What Is the Treatment for Nasal Injuries?
In cases of any injury during sport, and the athlete is conscious and bleeding, the initial step is to stop the bleeding. Using mild pressure gauze should be applied to the bleeding site. The athlete should be made in a sitting position and the head should be tilted forward, which will help the blood to drain out of the nose and will not drain back of the athlete’s throat.
If the athlete is bleeding in a lying position on the ground, gently roll the athlete onto their side to drain the blood out and onto the ground. If any serious head or neck injury is suspected, do not shift the athlete’s position, immediately call the emergency medical services.
After placing the gauze on the injured nose, check whether the athlete has any signs and symptoms of concussion-like,
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Headaches.
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Dizziness.
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Confusion.
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Nausea and vomiting.
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Inability to answer simple questions.
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Ringing in the ears.
If the athlete presents with any of the above symptoms, immediately call emergency medical services. After the bleeding is stopped, icing on the injured site may reduce the swelling. If a nose fracture is suspected, the athlete should be taken to the hospital for further management.
Nasal Fracture
Several treatment options are available to correct the form and function of the nose fracture. Soon after the injury, the bones can be manually pushed back into place in some cases, either in the operating room or doctor’s clinic, doing so can prevent surgery. But the nasal breathing and the appearance may not return to normal. Once the healing of the bone begins, a rhinoplasty can be performed, it restores the appearance and nasal breathing.
When Can an Athlete Return to Sports After a Fractured Nose?
Athletes can return to sports activity after a physician's approval to return back to the sport. The athletes may be advised to wear a protective splint or faceguard, which can be custom-made for the individual or purchased from sports medicine companies. The athlete is recommended to wear the face shield or guard for at least six weeks after the injury or until the doctor states that it is safe.
Conclusion
Nasal injuries during sports activity are very common. In most cases, the injuries are not serious, if there are any other associated injuries such as head or neck injury, then immediate medical consultation is required. Also, for nasal fractures, surgery may be required followed by adequate rest.
